James Watson and The Double Helix: There is always something more to learn, even if you were already a part of that portion of history

What a better way to illustrate the phrase, “there are always two sides to every coin” than the recently released, annotated version of James Watson’s The Double Helix?  Even further, it shows that at a young, naïve and ambitious age, one can never be sure that our assumptions and conclusions are correct.

The book, now full of previously missing letters, explains a deeper back story behind the tempestuous relationship between Watson, Crick, and Franklin that is presented by the 24 year old narrator, Watson, in the original version.  The conclusions made by Watson and Crick, influenced by gossip of other colleagues (Wilkins), about Franklin were mistaken, leading to resentment and misunderstanding.  The article, “The Turn of the Screw: James Watson on The Double Helix and his changing view of Rosalind Franklin” by Maggie Koerth-Baker at boingboing.net, illustrates this nicely.  The interview with Watson is insightful and really addresses his reaction to seeing the newly discovered letters for the first time, resulting in a sort of new found respect for what Franklin was put through by 3 eager male colleagues.

The article on boingboing provides what the more general review of the book in the November 13^th New York Times article, “Twists in the Tale of the Great DNA Discovery” by Nicholas Wade, is missing, an interview with the author.  I think that a similar interview would have given new life to this article, whereas now, it is a more general description of the additions to the book.  The author touches on salient and interesting points, but Watson’s changing views about people he worked with more than 40 years ago is what really grabbed my interest and influenced my decision to read the annotated version of The Double Helix.

The annotated version brings further evidence to light that Rosalind Franklin was indeed misunderstood and is under-credited for her work that lead to the discovery of the structure of DNA.  I definitely admire her strength and conviction to continue her work, though there was much opposition to her presence at King’s College, London.  I only wish that her take on the events of that time could be told, it would most certainly be a stark foil to the story presented by Watson.

A competitive, yet cooperative scientific environment

Natural disasters have a tendency to bring out both the best and the worst in people.  How better to emphasize the changing environment of scientific and biomedical research than to strain relationships to the max.

The November 6^th New York Times article “A Collective Effort to Save Decades of Research as the Water Rose” emphasizes just how supportive the scientific community has become.  When resources are tight, rather than heightening the competitive spirit, researchers reached out to competitors to aid in rescuing years of often irreplaceable scientific progress.  Sandy’s effect on scientific progress was diminished by heroic efforts to save years of research.

I’m excited to see that the trend in scientific research is moving toward cooperation, rather than competition.  In the past, competition for publishing a particular project first has been the driving force in scientific progress, but it brings about a sense of desperation to move as quickly as possible, which can mean that more mistakes are made.  This urgency and competition between researchers for monetary resources, leading to error, could be behind some of the recent retraction trend.

The spirit of cooperation can lead to more progress than in the past, by sharing resources, leading to more publications from one set of tissue or animals, thus more scientific progress.  It also seems that funding sources are also being more supportive of joint efforts, getting more bang for their buck by selecting to fund many more multi-investigator projects.

While the article definitely evoked emotion and focused on the big picture, the major driving force behind scientific progress, the graduate students were overlooked.  I do have hope that those researchers that offered to aid in keeping research projects on track, would also take on the students doing the research, so that maybe they can gain benefit from cooperation as well.

As a researcher myself, I couldn’t imagine loosing animals or tissue samples that were critical to a current or future experiment.  The article places a lot of focus on how the storm affects the overall progress of research, setting back programs and projects by years, but one thing the article does not address is how it affects students.  A PhD in this day and age can take an average of 4-6+ years, depending on the program, research topic, and research model.  This timeline is based on reaching a series of checkpoints, dependant on research progress and publication.  A setback of 10 years from the loss of a genetically altered mouse is indeed a catastrophe for the researcher and the field, but can also set progress back by years for graduate students.  The loss of samples and animals can mean a setback of a few years, making progress toward graduation ridiculously slow and actually beginning a scientific career could move from age 30 to much later.

There is much to be celebrated from this shining example of how amiable and supportive the scientific community can be.  Thanks to everyone’s effort we can look forward to future progress, rather than having to completely backtrack to replace lost materials.  I just hope that researchers will also remember the manpower behind research progress, and help students progress timely toward their future.

Correctly using your story arc–an article analysis

This week’s assignment was to analyze an article from the New York Times’ Science Times section. Specifically focusing on the components of the story arc and what elements make the story intriguing.

I focused on “Scientists Move Closer to a Lasting Flu Vaccine,” by Carl Zimmer. While the article is fairly lengthy, the format really keeps the readers interest. It presents the current conundrum, why we have to keep getting flu shots every year, and what direction researchers are taking to come up with a better, longer lasting solution. There isn’t a character being focused on in this story, but I feel that with flu season coming, most of the readers will be very interested in the how, why, where, and what’s next in the development of flu vaccines. The flu is not a fun virus to obtain, I can speak from experience, so I’m sure any information on prevention and development of an improved system would be well received.

The 3rd paragraph sums up the whole article, we’ve been stalled in terms of vaccine development for the flu since the 1950’s, but with the onset of several new research studies, at long last it looks like we may see long-lasting vaccines in our future. The first few paragraphs give the reader a jumping off point, knowing why the flu is so unique and how current immunological information has allowed us to begin developing new types of vaccines that target the virus in new and different ways that may provide solutions for not only the flu, but other viral diseases like HIV.

Moving on to the second page of the article, Zimmer continues to describe how our immune system can take advantage of the vaccine and contribute to enhanced immunological memory and a strengthened secondary response when attacked by the virus. I think that overall it is a reliable, understandable description, though I do take issue with his statement that scientists have to “guess which strains will be dominant.” I assure you that this is not merely a guess, but backed up with historical data and trends, along with information on the current evolution of the virus, and a statistical analysis to determine which strains to include.

The conflict created to keep the readers interest up to the climax is the fact that flu vaccines have been made and re-made every year since the 1950’s battling to keep up with the ever evolving flu. This vaccine is one of the only vaccines that needs this much upkeep and attention year to year, and the effectiveness really relies on researchers ability to predict its evolution and frequency within a population. The climax is reached about half way through the second page, when Zimmer introduces the researchers working on new ways to tackle the flu virus.

Specifically, he focuses on Dr. Gilbert, a researcher at Oxford that is focusing on a vaccine that targets T cells, rather than the traditional B cells. The other is a researcher at Scripps, Dr. Wilson that is focusing on creating antibodies against multiple flu strains, rather than just one. This technique is evolved from original research in Japan from 1993. This new researcher provides hope to the readers that in the future, a yearly flu vaccine may not be necessary and that they will be better protected over time, rather than having the chance of catching the flu strain that was not included in the shot (which was how I ended up with the flu a few years back). The quote obtained by Zimmer from Dr. Wilson creates a nice, cheery resolution, “The whole field is invigorated.”

While there is much hope to be had from current research, the last two paragraphs also bring this hope into perspective. Without stating directly that much more research needs to be done, he alludes to that fact by mentioning an issue that researchers have to overcome for some of this new technology to be implemented. That is, getting the immune system of each individual to produce enough of the newly created antibody to be effective in battling an onslaught of any strain of flu virus.

Though the article is quite science/information heavy, it provides information that is critical to understanding the current state of flu research in an easy to read and understand format, using a traditional story arc with conflict, climax, and resolution.

Why progesterone in the prevention of preterm birth?

The miracle of birth and why it occurs the way it does, especially in humans is still quite a mystery.  The inquisitive scientist in me was quite intrigued by the article “Limits of Progesterone in Curbing Early Birth,” by Nicholas Bakalar in the Oct. 23 edition of the New York Times, which explains the latest developments in research for prevention of premature labor/birth.  While the recently published study, which was the peg behind the story, was well explained, I felt the need to dig a little deeper and answer a few more of my own questions.

My research typically focuses on one end of the hypothalamic-pituitary-gonadal (HPG) axis, particularly the hypothalamus, I have had some exposure to the gonadal and pituitary end, via a reproductive physiology class.  As the scientific research machine continues to chug onward, I was surprised to find that much of the material that was taught in my class, less than a year ago was now out of date.  There have been significant advancements and new theories hashed out to explain why/how labor is naturally induced in humans and what doctors can do to delay it.

The HPG axis is the interaction between three critical endocrine organs of the body, each providing variable amounts of different hormones and interacting with each other via positive or negative feedback loops, to regulate bodily balance, homeostasis.  This is a really complex, nuanced system, but those are the basic nuts and bolts of it all.

One of the hormones that interacts within the HPG system is progesterone and it is the focus of the NYT’s piece.  Where they explain, how in a new study, progesterone injections were given to women to see if it could dramatically reduce the number of preterm births in women that have a cervix shorter than 30 millimeters.  Previously, it was found that progesterone vaginally reduced the number of preterm births among women with a cervix shorter than 20 millimeters.  As the success of the vaginal form of progesterone was found in 2% of the population, the number of women with a cervix length of less than 20 millimeters, the authors of the current study desired to expand the market, attempting to help women with cervix lengths 10 millimeters longer.  However, an injection of progesterone was used rather than vaginal administration, the injectable was found to be effective previously in women who had had previous preterm births.  No significant effects were found.  Now this could be attributable to several factors, the route of administration could be less effective, or that the women that were focused on need some other treatment to prevent preterm birth.

While the story nicely highlights the current study and several different studies that lead up to it, the information required to understand the underlying theories and research responsible for the medicinal advancement was probably outside the scope of the word limit provided.  Therefore I’ll attempt to expand on some of my own questions and the results of some digging into recent publications.

Why progesterone?

From the beginning of a pregnancy, progesterone is critical to pregnancy retention, it is produced until the placenta is developed about two months into the pregnancy, where it takes over the task of maintaining the developing embryo.  This role in maintaining a pregnancy is where progesterone got its name, “pro–gestational steroid ketone” (Norwitz, Phaneuf, Caughey). 

Later into the pregnancy, progesterone’s role is not quite as clear, though there are several theories that progesterone acts to inhibit the action of a multitude of other signals and molecules that are developing to initiate the start of labor, including the action of prostaglandins and the activation of oxytocin receptors (which are responsible for uterine contractions).  Note: uterine tissue when placed in a dish, without progesterone signaling, can begin to contract spontaneously.

This theory behind progesterone acting to suppress all the other signaling mechanisms that tell the body to initiate labor is why it was initially tested as a drug to prevent preterm labor.  The thought was that if during a normal pregnancy it is naturally used to prevent labor, then it may also be effective when medically administered.

How recent is the approval of this treatment?

Several clinical trials were completed using different dosages, administration methods, and women in different risk categories for preterm birth.  Positive results were found in a few of these trials, leading the FDA to approve the use of progesterone during pregnancy to prevent preterm birth in February of 2011.  The approval indicates that injections of progesterone can be used effectively in cases of prior spontaneous preterm birth.

More recent studies have indicated that in cases of extreme cervical shortening, vaginal suppositories can be effective in reducing preterm labor, leading to the focus of the study in the NYT article.

Why is preterm birth/labor so prevalent? Why is it an issue?

Premature birth, or giving birth before 37 weeks of gestation (full term), accounts for 85% of perinatal death and complications in the US.  1 in 8 births can be affected.  Based on data from 2008, the rate of preterm birth has increased by 35% in the last 25 years, thus there has been increased interest in prevention over the past decade.  The reasons for this increase in premature birth are rather elusive to scientists, though there is a prominent theory that it is associated with an increase in maternal age.

Why would increased maternal age result in increased numbers of preterm births?

Well, the researchers behind a recently released study, “Metabolic hypothesis for human altriciality,” in the August 29^th edition of PNAS, by Dunsworth et al, would probably lead you to believe that it may be associated with decreased metabolic capacity of the mom.

Their theory is that the induction of labor is initiated when the mom’s metabolic ability to support the growing fetus reaches a certain threshold.  When the mom cannot burn enough calories a day to create energy enough to support both herself and the fetus, then signals are released to initiate labor and birth.  Because an older mom would have a decreased metabolic rate, her capacity to produce energy would be reduced, thus birth would be initiated earlier than in a younger mom with a faster metabolism.  This lifting of suppressive signals (including progesterone) results in labor.  Thus, providing progesterone to an older mom at a high risk of preterm birth would/could synthetically keep providing the inhibitory signal, which may already be lifted in the body, that is needed to maintain pregnancy.

Do we know for sure?

The mechanism by which a fetus, when fully developed, stimulates the release of labor inducing hormones in mom is well defined in species such as cows, however humans lack the enzyme that seems to work as the trigger in bovines.  Thus, researchers are still puzzled as to how labor is induced, is it because of metabolic limits, signals from fetus that says “I’m developed,” or another mechanism? We still don’t know.  We only have theories to work with for now, though potential hypothesized mechanisms, which are being tested currently, are plentiful.

Norwitz ER, Phaneuf LE, Caughey AB. Progesterone supplementation and the prevention of preterm birth. Rev Obstet Gynecol. 2011 Summer, 4(2):60-72.

Norwitz ER, Robinson JN, Challis JRG. The control of labor. N Engl J Med. 1999;341:660–666.

Challis JRG, Matthews SG, Gibb W, Lye SJ. Endocrine and paracrine regulation of birth at term and preterm. Endocr Rev. 2000;21:514–550.

Dunsworth HM, Warrener AG, Deacon T, Ellison P, Pontzer H. Metabolic hypothesis for human altriciality. Proc Natl Acad Sci U S A. 2012 Sep 18;109(38):15212-6. Epub 2012 Aug 29.
doi: 10.1073/pnas.1205282109

Pitching Mental Floss

So I recently pitched 3 ideas to Mental Floss for their College Weekend extravaganza (ie where they feature stories on a particular weekend from college students).  I thought this was a great way to get my feet wet in the science writing world, so I pitched 3 science heavy ideas.  And, as they were asking for pitches from College Students in particular, I figured there would be a much better shot of getting an idea approved.  So out of animals that can regenerate body parts (which I thought was appropriate for upcoming Halloween), neurons and neuronal families with interesting names, and “18 gene names that cover the Gamut, From Movies to Pop Culture to Cartoons,” the later was the one that I was asked to write up.  I think that this is a great forum for new writers to have an opportunity to show off their talents and I hope they continue the College Weekend tradition.

Here’s a link to my published story:
http://www.mentalfloss.com/blogs/archives/148072

Writing the story was a blast, I got to combine pop culture and science, both of which I enjoy, though they don’t mix frequently.  I did, however, really have to concentrate on lightness of my tone, as most of Mental Floss’ articles are most always quirky and funny, I felt like I had to move further away from my more technical, serious, sciencey tendencies.  I thought I ended up with a good mix of humorous anecdotes and correct science, hopefully most everyone agrees.

I do also really appreciate the support from other science writers, and my teacher, from my science writing class.  The promotions and tweets to links to my piece are great ;).

I’m sure this is why knowing people in the industry absolutely makes a difference in how successful you are.  If you have people to back you, you most certainly will get far.

Evidence of this great support is David Kroll’s piece in Terra Sigalata, my science writing teacher’s blog at ACS:
http://cenblog.org/terra-sigillata/2012/10/29/naming-genes-unlike-named-reactions/

I really enjoyed the experience and look forward to pitching more stories!

Running barefoot without actually running barefoot

The latest and greatest trend in running in the past few years has been barefoot running.  The spark behind this trend was research on our ancestors and some current native populations that run faster, better, longer without shoes.  I’ve been interested in this topic along with the Tarahumara people, ever since watching a documentary on running and ultramarathons a few years ago, however I haven’t been able to find the link to the exact video.  I know it was on a cable science/history channel, but I can’t remember which one.

Recent research has delved into why this is the case and how runners today can gain that benefit.  Some runners choose to run fully barefoot, but I’ll have to admit that makes me a little squeamish.  What about stepping on/in something that could damage/contaminate your feet?  I’m sure this sentiment is why there is a whole market of shoes that mimic the barefoot feel, while still providing some protection, and peace of mind.  One barefoot running shoe website I found via Google search offers 15+ brands with hundreds of style and color options.  I recently went with my Dad to pick out some new walking shoes, as he wanted to try some of these lightweight, non-shoes, so I’ve seen firsthand the extensive variety and marketing associated with this new type of shoe.

As runners have now had a chance to try out these shoes or lack of shoes, there have been some mixed results as to the benefit of this technique, so delving further into the scientific results helped to shed light on the subject.

A recent story in the New York Times, “Myths of Running: Forefoot, Barefoot and Otherwise” by Gina Kolata, highlighted several recent studies, and helped my interest in delving further into the subject.  The story talks about who uses which style of running, how much energy is used with/without shoes, and if we all ran in the same style, would running with or without cushioning be better.

The story never really goes into defining what all the styles actually mean, so I’ll give it a shot:

Heel striking:  The heel is planted first, followed by the forefoot, in sort of a rolling motion, like a wave.

Midfoot striking:  Both the ball and heel of the foot land at the same time.

Forefoot striking: The ball of the foot is planted first, followed by the toes and heel. (This is different than the forefoot strike that sprinters use, when they run, their heels hardly ever touch the ground.)

It turns out that there isn’t really one style that is better than any other, research actually suggests that running in your natural style is the most productive and energy efficient.  Your body knows what’s best for you.  The research reported in the article also suggests that complimenting your style with the most appropriate footwear is the combination for the best results.

Research behind the results of traditional running shoes suggests that approximately 75% of people that wear these shoes convert into heal strikers, leading researchers to hypothesize that this is behind repetitive stress injuries seen in the running population every year.  With the sole of a traditional running shoe being so think at the heel, no wonder most people turn to heal striking, its where there is the most cushion and comfort.  However, this divergence from a natural stride, which is hypothesized to have been comprised of a mostly forefoot strike population in one Harvard lab, has been the driving force behind getting back to nature and the “barefoot” experience.  There is no sound evidence that heel striking is inherently bad though, Dr. Hunter’s results, summarized in the NYT article, indicate that many distance athletes actually fall into the heel striking population.

So if there is a wide variety of acceptable styles, that are equally effective, depending on your natural stride, then what is actually more efficient, running with some cushioning or without?  The interesting results based on a study to answer this question are also summarized in the NYT article, only looking at midfoot and forefoot strikers, 10 millimeters of padding actually allowed runners to expend less energy than their barefoot partners.   This is an extremely interesting finding as previous research indicated that barefoot runners expended less energy than people running in traditional shoes, which is pretty logical as they’re toting around less weight, but some cushioning, according to Dr. Kram, does provide benefits.  So in the case of barefoot running I guess a little does go a long way.

So what’s better for you? Barefoot running? Traditional shoes? Minimal shoes?  Forefoot striking? Heel striking?

The answers at this point are all “it depends.”  As with much science today, there are many qualifiers, what is your natural gait? What surface are you running on?  Are you trying to switch gaits?

There isn’t a “correct” universal method, you have to do what is best for your body and use what you were given the most efficient way possible, which probably involves consulting a doctor and athletic shoe fitting specialist if you are serious about getting into running or trying to change your running equipment and/or style.

Common questions from new science writers answered-Guest Lecturers Jennifer Ouellette and Maia Szalavitz

Starting out as a new science writer, dues have to be paid.  It seems like every writer we speak to tries to encourage us to never write for free, to use our very best material to make money.  However, to be paid to write, the editors picking up your pieces have to have a certain level of confidence in your writing ability, especially if they’re paying you to write based on just a pitch.  How then do you demonstrate that you can write without having any clips?  Well, it seems to come down to the fact that in the beginning of any journalist/writer’s career, some free work must be done, to create a few clips that demonstrate just how awesome you indeed are.  (Cue plug for the benefits of blogging).

Blogging turns out to be a great public forum to demonstrate your abilities to editors, to show that you do have the chops to write pieces they might be interested.  Having just a few pieces on a blog may be the key to getting your foot in the door at a publication, leading to first official clips, notoriety and the ability of needing to write for free to writing only for pay.  I’m sure initially after the first few clips that there is a gradient or exponential growth curve related to the time it takes to accomplish 100% paid writing versus, a combination of writing for free and some paid gigs, but as in pretty much all fields, once your dues are paid, success can be within grasp.

I’m pretty sure that I won’t be a full time freelance writer any time soon, my current goals are to be able to discuss scientific literature and communicate it to lay audiences, helping to promote understanding in whichever topic is currently at hand.  Maybe it will evolve into supplemental pay for my current graduate student salary, which allows me just to squeak by.  I think my path will differ from the traditional full time science writer in that I want it to compliment my scientific work, and allow me to have fun exploring topics other than my specialized niche of study.

Helping us to parse out the conundrum of how to start out as a science writer, we (my English 520 class) were privy to two guest speakers this past week.  Jennifer Ouellette, a physics science writer and author of The Calculus Diaries, was kind enough to share some advice and her own experience to help us answer these perplexing questions: How to choose what material goes to paying publications vs. personal blog? and How to write articles that have not already saturated media coverage when released from embargo (when you’re not a well-known writer and don’t get advance copies of studies)? Maia Szalavitz, writer for http://www.thefix.com, Time Healthland, and Salon, also visited (via Skype) and discussed the difference between journalism and advocacy, as well as how to best differentiate yourself as a writer.

Jennifer Ouellette’s visit
Starting out as a new science writer, we lack one distinct advantage that experienced writers have earned, getting early access to newly released papers and results.  To compensate, Jennifer recommended taking a new fresh angle on something that has thoroughly saturated the media.  Her suggestions were to insert a personal experience, to connect you to the new research, or to look places in the paper that writers on a deadline don’t typically have a chance to get to.  She recommends the methods section, which can bring up some interesting questions, like where did they get their sample? (The answer to this question was especially interesting in an article she wrote about sperm sorting).

To get this new/fresh angle published, the “wow factor” must be emphasized early in a pitch, showing how this story will be great, new, and unique.  A science story has to have all the good characteristics of a traditional story with science melded in the middle.

Don’t just tell the editor that the new science is cool, they probably already know that.  Write the background story that makes the science come to life, in descriptions, anecdotes, etc, “anything to make editors start seeing it in their head.”  Describing who you’ll talk to about it, prior work on a similar topic and why the new work is significant are all good ideas to really sell a story.

Remember:  the story elements are what help readers get over the mentality that “science is hard.”  If they are enjoying the story, then the science won’t seem so intimidating.

If the story doesn’t end up getting picked up based on fabulous, well phrased pitches, then don’t let your work go to waste, you can always pitch it to another publication, or put it on a blog, so that the public has the benefit of reading it, and the work put in to writing it won’t seem like such a waste.

Jennifer’s take on blogs is that typically she saves press releases to be used in blog posts that she needs to complete on a daily basis; this leaves room for more historical information with a complete picture as to the significance of a story, and this prevents from further over-saturating media outlets with similar information.  Stories that she pitches to publications for pay are ones that have a lot of character, a life of their own, and that have a fresh angle on trends that no one else has picked up on.

Skyping with Maia Szalavitz
Writing is hard.  It is something that you can improve with practice, but something that you have to practice a lot.  Mistakes will be made, never fear, but use them as learning experiences and tools to improve.

“You really do get better if you practice.”

Maia was so open to share her experiences about what got her into science writing, that no one in class could doubt her passion for the craft.  Her drive to “get information out there,” to explain confusing research and debunk myths, especially in the addiction field, is what drove her to start writing.  Her writing daily puts her on the fine line between advocacy and journalism, helping to define that line and keep to good science, was her sage advice.

 “Back up your own experience with sound research.”

Your experience may be that 1%, an outlier, in reference to the experience of the masses.  If just writing based on experience, you can further muddle the truth in an already murky and confusing pool of literature.

“Write what you know, but remember, just because you have had brain surgery, doesn’t mean that you’re a brain surgeon.”

Her tips on differentiate yourself from the pack includes:

1. Take a basic stats class, as correlation ≠ causation.
   Just learning and understanding the basics can often give you a great head start when going up against other journalists.
2. Specialize as much as possible, it narrows the competition.
   Having a subspecialty can also allow you to get to know sources and editors more intimately, and they begin to recognize you as someone who can cover that subject, eventually leading to publications pitching you, the writer, to write certain articles.
   If the thought of specialization makes you worry that there won’t be enough variety in your life, Maia also suggests that variety can also come in the form of the piece, whether it’s a short 300-400 word piece in a local newspaper, or a 3,000 word expose in a major magazine.
3. “Your own authentic experience is often what you’ll write best about.”
4. Take direction from editors.
   Not only can this dramatically improve your writing if you learn from each experience, but being civil and showing that you’re willing to learn and adapt your piece to fit the publication can be to your benefit.  I’m sure that editors really do remember the nice writers, as much as they remember the writers that were a pain to work with.
5. Don’t just report on the fancy, shiny new discoveries; be sure to balance the exuberance over a topic with potential limitations.  Try to show people more about how science works.  That way, they don’t get disappointed and unenthused about science as a field, especially when that glittery piece of reporting that came out last year about a cure for this or that ailment didn’t pan out.

____________________________

I really enjoyed both talks and feel like I learned a lot about how to make myself a better and more marketable writer.  I look forward to applying these suggestions to my writing.  Thanks Jennifer and Maia!

The More Downs than Ups of Electronic Medical Records

Hark back to the thought processes of the 1970s and 80s when the ‘bad’ science fiction movies were filled with technology, robots, were taking over the world from the humans who created them.  This is the sensation that I got from the Oct 8, 2012 article in the New York Times, “The Ups and Downs of Electronic Medical Records” by Milt Freudnheim.

While the title suggests that the article will speak to both the benefits and issues with electronic medical records, the author was much more heavy handed with the downfalls.  The article was fairly gloom and doom about the whole situation.

Don’t get me wrong, I realize that there are definitely bugs to be worked out and that it looks like it will take time to work them out, but downplaying the potential benefits to patients and doctors alike of this new technology is not the answer.  In this case, where neither the software manufacturers, nor doctors, nor patients really have an idea of when and how the technology can really be beneficial, or if it will turn out to be a detriment to patient healthcare, it is much better to present both sides of the argument and let people make their own informed decisions.

The first portion of the article really emphasizes that currently, unfamiliarity with the software systems is bogging down the system, and this is probably true, but wasn’t that also the case with the first computers, where there absolutely was a steep learning curve.  Fortunately, now computers are a staple in everyday life and are making lives much easier and more productive.  This is also emphasized in another article in the NYT on the same date, “Redefining Medicine With Apps and iPads,” by Katie Hafner.  Nurses and doctors alike will likely have to go through hours of training and overcome the habits learned over years on the job and professional training of writing everything down on paper, but benefits may eventually outweigh the problems that are currently being brought to light.

In the middle portion of the article, several good points are brought up about the current state of technology. Dr. Scot M. Silverstein raises a good argument, that indeed testing technology in a live hospital setting is probably not a good idea, much less ethically correct.  This is why there are simulators and even training tools, where a mock system with imaginary patients could be used in training to practice using the system, and where hospital administrators and doctors could determine whether the system that is being tested is correct for the hospital it’s being used in.

Cross talk between systems and apps is also brought up, until either a universal system is created to be used in all medical institutions, or a set of systems are designed to infallibly speak to each other, without translational issues, institutions are going to have to implement safety measures to ensure that what a computer system is transmitting, is indeed correct.  Medical professionals are still going to have to use common sense and not just rely on technology.

The industry will definitely have to design new safety measures to handle these new standard operating procedures in order to protect the patient and ensure the highest standard of care.   This is not new, and new safety measures are being implemented daily, but with technology a new kind of safety measure will have to be created.  People have to be willing to learn and evolve with technology, not let these ‘new fangled electronic gadgets’ stymie them completely.

In the last part of the article, I thought one quote was particularly amusing.  Dr. Scott A. Monteith is quoted saying:

“the diagnosing process can include ‘looking at six pieces of paper,’ he said. ‘We cannot do that on a monitor.  It really affects how we think.’”

I have no idea how old this doctor is, but the quote reminds me of some of the previous generations’ attitudes about technology, that just because it is not the way ‘it’s always been done’ that it can’t be correct.  I’m not sure how much exposure he has to technology, but there are ways to have multiple monitors linked together, to where indeed you can look at 6 documents at one time.  Granted, you can’t read them all at one time, just like with paper, you have to read one at a time, but you can get the same effect as laying them all out on a table to analyze trends and similarities, having them all visible on 2 or 3 monitors that are linked together.

One character in this story, Ms. Burger, president of the California Nurses Association, also brought up an interesting issue, stating:

“‘The problem is each patient is an individual, we need the ability to change that care plan, based on age and sex and other factors.’”

She is absolutely correct, that the software being used to enter records, diagnoses, and order medications should not be plug and chug with just a few options based on standard of care.  Medical professionals should have the freedom to use their expertise and previous experience to treat patients with drugs and treatments that they feel will be the most successful for each individual, as she stated correctly that “each patient is an individual.”

While this paragraph in the story was supposed to bring up more issues about the current state of technology when it comes to electronic medical records, I’d like to bring up the possibility of benefits in the future.  Personalized medicine is thought to be the wave of the future, using individual genetics to customize treatment.  While genetic sequencing is still on the expensive side, the price is steadily dropping and eventually we will probably have a sequence for everyone in their medical records.  This could allow a software system to analyze the sequence and give the doctor or nurse warnings about patient sensitivities to drugs or an idea about which drugs will be effective based only on comparison of genetic sequence or even epigenetics.  Cross referencing previous treatments, genetic sequence, and available treatments via software, could allow for each patient to be treated even further as an individual, making unique treatment plan design much quicker, without some of the trial and error.  For example, current genetic analyses, such as from the website 23andme.com shows when patients have a higher likelyhood of being sensitive to the drug Warfarin, an anticoagulant, even before being treated with the drug and finding out the ‘old fashioned way’ that there could be an issue with sensitivity.  It could allow medical professionals to change drugs or adjust dosages based on the way the patient metabolizes the drug, all found via genetic analysis.

Some other potential benefits that went unmentioned in this article include eliminating the need for double procedures, decreasing the likelihood of being prescribed drugs that interact badly from two different medical institutions, and decreasing the likelihood of drug addicts being able to play the system and obtain multiple prescriptions for the same drug.  All of these benefits require rapid sharing of information between institutions and likely not be implemented or seen for awhile, though the potential is striking.

The lack of need for double procedures, like imaging, blood work, etc would allow patients to be protected from unneeded radiation exposure or more needle pricks if referred from one institution to the next, instead of repeat procedures to get the same results, all the image scans and blood work reports could be rapidly and easily passed from one place to the next (think inter-institutional e-mail) or accessed in a universal system.

Prescription records that are widely accessible to pharmacy, hospital, and doctor alike, with safety measures in place, like the little pop-ups in gmail that remind you that you have not added an attachment if in your e-mail it says ‘see attached,’ doctors could be quickly warned if he/she is about to prescribe a drug that is known to interact with another drug the patient is already on.  A similar system could warn doctors/pharmacies that a prescription for opioids or other addictive drugs have already been prescribed.

While there are many kinks in the development of this technology to still be worked out, I think there is more promise than what this article would have you believe.  It is still really early in the game, but as technology gets better and professionals become more familiar with the options, I think this is the future of medicine and how information will be shared.  The majority of the issues presented are valid and should be taken into consideration and it may be a little early for universal implementation, but I think this industry lends more hope for the future than a need to toss it all out the window and start from scratch, as the tone of this article would lead you to believe.

Building a Career: From bugs to belly buttons – Guest Speaker Dr. Holly Menninger

If you want an example of a person using multiple life experiences (aka jobs), all of which were not “perfect,” to lead you to a great job/career that makes it all worth it, then Dr. Holly Menninger is the example for you.  She was invited as a guest speaker on Tuesday, September 25^th, 2012 to our ENG 520 class as the Director of Public Science for the Your Wild Life project.  As part of her job as director, she gets to enthusiastically engage the public, introducing them to glorious scientific knowledge, write, record podcasts, and play with bugs, all of which are passions developed over the beginnings of her career.

What at glance would seem a haphazard transition from Ph.D. in entomology, appearances on CNN (as a bug publicist), to work in science policy, to creating a weekend science radio show/podcast (on a volunteer basis), all have their purpose in allowing Dr. Holly to succeed in her current role as Director of Public Science.  She exudes a passion for bugs, which began early, as she would tell it, but 17-year and 13-year cicadas emerging from the ground to “do their thing” is what launched the transition from pure interest in studying these creatures, to interest in public education of scientific phenomena.  Creating a buzz (pardon the pun) around the emergence of “giant bugs” that make a lot of racket and that could be perceived as the beginning of the apocalypse, if the public was not educated about the natural life cycle of these bugs, was invigorating.  Her excitement about the topic, vicinity to major news outlets, and the fact that her PI was doing Good Morning America the same morning, allowed her to be the perfect “bug guru” for 6 episodes on CNN.  This first major exposure to public, mainstream education was trial by fire for Dr. Holly and from her comments, it seems that this is how she learned the most about how to be the interviewer and interviewee.  A relatively brief stent as a science policy liaison with a side project as a science radio show host showed her that absolutely wanted to follow her passion, educating the public, rather than dealing with the paperwork mess of policy for a career.   Thus the transition into the Your Wild Life project, where she can play with bugs, create podcasts, educate the public, and use the information she gleaned from the science policy job to really influence the lives of the public around Raleigh, and the rest of the country, investigating microbiomes that are a little closer to home than we’d like to imagine, bugs in our homes, bacteria in our belly buttons, and not to mention what lives in our armpits!

She and her comrades strive to make bugs a little less yucky and a lot more educational and exciting for young scientists and other inquiring minds.  The projects they are working on engage citizen scientists to investigate and sample for themselves and contribute to the pool of samples from urban and suburban local areas.  The Your Wild Life team strives to “Explore the biodiversity that lives on us, in us and around us,” so if your game, the participation information is on the groups’ website, yourwildlife.org

The theme of class was interviewing skills for the interviewer and interviewee, as our class is a mix of scientists in the making and Technical Communications students, so we will all probably be on both sides of the coin at one point in our careers or another.  To address this theme, along with telling her wonderfully inspiring story, she gave us tips about being both the interviewer and the interviewee, which I will summarize below:

For the interviewee:

• Focus on the 5 P’s: Prior Practice Prevents Poor Performance

Think about your main message when approached about an interview, take five minutes to organize your thoughts and get your talking points together.  If you know ahead of time that your story or research is likely to make headlines, do a little preparation to be sure you deftly cover appropriate issues and give the most factual information possible.

• Stick to no more than three talking points, which emphasize your main message.

Too much information can oftentimes detract and distract from the message that you really want to convey.  The “triangle method” was how Dr. Holly presented graphically the 3 points and a main message mantra.

• Ask the “Why me?” question.

Knowing why you are a person of interest to be interviewed and what spurred interest in the subject can give you a great head start into knowing what information will be relevant to the interviewer and what may allow you to make the most positive and pertinent press about the issue.

• Get your facts straight.

Probably the most important tip for the interviewee, this is the way to gain good exposure as an expert, if you misspeak or fudge information because you don’t know the answer, the journalist may not come to you again, because you’re not a reliable source.  The best policy would be to say you don’t know (if you don’t), look up the information, and get back to the interviewer later.  I’m sure most scientists and science writers value accurate reporting of facts at a later time, rather than a quick, inaccurate quotation.  Good punchy facts can also potentially make powerful quotes, so doing your homework and being prepared can make a big difference in getting your message across.

• Take journalists into the field, it can add ambiance to a story.

There is nothing better than firsthand experience to lend a little spark to a story, not to mention providing photo ops or sound clips.  Dr. Holly’s example of taking a journalist literally into the field, a field of cicadas, surely contributed to later reporting.  She described what the cicadas were like at their time of emergence and that the researchers and journalist were literally shouting at each other to be heard over the din of the bugs chorusing.  What kind of journalist wouldn’t mention that in a story?

•  Misquotation will happen, just roll with it.

Take the instances of misquotation, which inevitably happen in the transfer of information (think about the childhood game of telephone), something might be misheard or misinterpreted, as a learning experience.  Think about how you could have described it so that the interviewer, next time will fully understand.

You can also use your resources to correct or explain the misquote, linking to the story in your personal blog allows you space to fully explain a statement and communicate why it was wrong or out of context.

We also discussed the fact that if you do get interviewed, it is likely that at some points a quote you provide will not make it past the cutting room floor, don’t take it as a slight; there are absolutely word limits to be made.  Also, it may have been your information that provided the appropriate background to make the story come alive, so use interviews as times to educate, rather than expect big quotations to come out of it.  Being polite and approachable regardless of whether you get a quote or not, may lead to journalists coming back in the future or referring colleagues just because you are a good source.

For the interviewer:

• There is a fine line between knowing enough to ask intelligent, relevant questions and knowing too much, where questions are too in-depth and you lose the audience.

Most of the time, writing stories and interviewing on subjects that are foreign to you can be easier than subjects that you are intimate with.  Taking a broad base view is more appealing to people who know nothing about a topic, they’re more likely to be able to understand the story if you get at the big picture; whereas,  if you’re already an expert in the field, you make hone in on questions and details that fly way over the head of a lay audience.

• Send questions ahead of time.

This tip definitely comes with caveats, if you’re trying to catch time sensitive information or get off the cuff comments about a controversial topic, then spontaneous interview is probably the better bet.  However, if you have the freedom to send them ahead of time, then you can have an interviewee that is prepared with great facts and potential quotes.

• Have more questions prepared than you know you’ll be able to ask.

Nothing is worse than running out of material before the interview is supposed to be over, so being over prepared is key.  Also, feel free to go off script and ask questions that delve in deeper to answers that the interviewee has given, it can give depth to a story and take it somewhere you hadn’t expected.  It also shows you’re listening, which moves us into the next tip.

•  Listen to the guest.

Is the answer interesting?  Are there any follow-up questions that would be great to fill out your story? Do you need clarification?  Did they actually answer the questions?  These are all questions that couldn’t be answered on the spot if you aren’t actively listening and engaged in what they are saying.  You may also get more passion from the interviewee if you listen rather than robotically go through your list of questions.

• If the interview doesn’t work out, go to idea #2.

Some people just aren’t naturally enthusiastic or willing to answer questions in an open format, so if you get an interviewee that is a dud, be polite, but don’t be afraid to scrap the material.

Sometimes, you can bring people out of their shells to open up if you ask things unrelated to the core of your interview, ask them about a picture on your desk, or art on the wall, or what their interests are; getting them to loosened up and more comfortable with a more neutral topic can make the flow of the interview better.  And hey, you may learn something fun about the person to throw into your story.

• Embrace the long, extended, pause.

If there is a lull in conversation or a question than stumps the interviewee, don’t feel the need to fill the void.  Oftentimes, people become uncomfortable with this pause and begin to talk freely just to end it.  This may lead to unsolicited, interesting stories, as well as tidbits of information that the interviewee might have not meant to reveal.

______________

I really feel blessed to have been able to be present in class during these guest lectures.  The science writing community is so open and willing to share great advice and life lessons with newcomers, which you don’t find in many other fields.  I’m sure this information will be of great use in the future, especially when it comes to writing our first formal pieces, which will require extensive interviews.  I also am glad Dr. Holly shared the information about being an interviewee; I will be more than prepared to give an interview, if my research ever sparks a news frenzy.

Starting Things Off Write – Guest Speaker: Bora Zivkovic

A little background into this post before diving in:  I am taking ENG 520 Science Writing for the Media, taught by David Kroll.  The class is about how to write articles about science for the general media, so that lay audiences can gain insight into the goings on of the scientific community.  Bora Zivkovic was the first guest speaker invited to talk with our class, our assignment to prepare for his visit was to read several of his blog entries, which I have linked to periodically through my reflection.  The format of the visit was a very open ended interview, which allowed the majority of the class to have their questions answered about science writing, blogs, writing formats, job opportunities, and personal anecdotes.  I really gained a lot from his visit, most importantly, that I can be a science writer.  Below is my formal reflection on his visit.

I’ll admit when I first heard that we’d be blogging, hearing from bloggers, and reading blogs I was a bit nervous.  I had the general impression that blogging was for those so bold as to put personal diaries online, so once I began reading, I was quite surprised to see people using it to communicate knowledge, parse out thought processes, and critically analyze publications from mass media to scientific journals.  I think my original fears came from my parents’ and school teaches’ ardent lectures about taking care not to reveal too much on the internet, as this could be dangerous.

In some cases they are right, there is no way that I’m going to be publishing addresses, social security numbers, etc online, but then I’ve  also begun to wonder if not having enough online is also a  bad thing.  Could you lose out on potential opportunities that shameless self promotion and publication of a reasonable synthesis of scientific ideas could present?  Would it be better for potential employers to have an idea about your capability and personality beforehand? Bora Zivkovic’s answer to both of these questions would most certainly be yes.  His straightforward, stream of conscious, write until you’re done explaining, style is informative, creative and admirable.  He’s taken off with a new trend, well new since the 20^th century, and adapted it to current technology, evolving as the world of science journalism evolves and helping to stand tradition on its head.  I greatly enjoyed our class’ opportunity to discuss with him the ins and outs of his journey in scientific writing and here I muse on some of the topics he brought up.

Bora very deftly describes that the idea that the mass media is 1. the end all be all in news authority and 2. completely accurate in their reporting is crazy, you have journalists with no expertise in science translating it for lay audiences, which definitely has the potential to turn out very badly.  As he realized the potential in blogs early on, he’s helped to popularize the modern outlets for writing, which has allowed for a style of writing and reporting to return that was lost for a blip in the timeline of the earth, aka the 20^th century.  By sharing everything and hashing out ideas in mass, with everyone contributing thoughts and critique, this may help a lot of the bogus science to be brought to light, and for the progression of discovery to move at a faster clip.

Bora also brought up the need to be extremely critical when you’re reading, as even in peer reviewed journals, garbage has a tendency to get shoved through the cracks.  With this thought in mind, blogs are an excellent way to discuss the latest science news and publications, getting multiple points of view from a variety of sources, via the comments section, to hash out what is good science and what is hogwash.  One of his suggestions was very insightful, in that you can use a blog as a think tank to work out new ideas, but I’m not too sure this will catch one with prominent scientists too quickly, as most are very protective of new ideas that could be stolen.  I also wonder about how I will personally be able to handle some of the critiques that come from allowing writing to be available to the masses, especially in light of the recent ENCODE circus.  Bora’s thoughts on the matter were helpful in my musings over this matter; he talked about “attacking ideas not people,” a way to critique someone’s writing without bashing it, which can also be used in the reverse, take to heart the content of the criticism, but taking the criticism personal.  Keeping this in mind will allow me to use critiques from the public to grow as a new science writer, rather than shrink back away from my thoughts and principles.

I very much appreciated his openness about how he got some of his jobs; the stories were comical and incredible at the same time.  Who knew you could get a job via blog post? It just goes to show that indeed, having an online presence and a loyal readership can get you pretty far on the job front.  Based on some of Bora’s comments it seems expertise and trust from your readers is absolutely developed over time, along with deftly placed links to resources that can verify your thought processes and resource; this should definitely be kept in mind if you want to science write for a career.  However, if you’ve got a creative streak and an ability to integrate other disciplines with science topics, then you may catch the Blog Father’s eye and be on the fast track to notoriety.  Bora tries to promote and encourage new science writers through mentoring and opportunities to post your work on sites like Scientific American, where he is currently an editor and blog community facilitator; he may also tweet up a storm about a post if he likes it enough.  This attitude of encouragement seems to permeate the science writer blogosphere with veterans promoting newbie’s work; the key to success according to Bora, it’s all about just getting your stuff out there for other curious minds to find.